• Title/Summary/Keyword: 의료인지지

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Quality of Life Changes in Patients Admitted to the Hospice Unit (호스피스 병동 입원 환자의 삶의 질 변화)

  • Park, Theresia;Song, Hae-Hiang;Seo, In-Ok;Cho, Young-Yee;Park, Myung-Hee;Heo, Jeong-Hee;Kim, Eun-Kyung;Park, Sun-Ju;Ra, Jeong-Ran
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.18-27
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    • 2000
  • Purpose : This study aims to find out the quality of life of patients admitted to the hospice unit at Kangnam St. Mary's Hospital, at admission and after weeks hospice service and to assess the effects of hospice service on the quality of life of terminal cancer patients. Methods : This study subjects were 100 patients admitted to the hospice unit at Kangnam St. Mary's Hospital, Catholic University between October 1999 and March 2000, and their primary caregivers. Quality of life data were collected using a questionnaire revised by the authors and were analyzed by means of repeated measures ANOVA. Results : 1) Patient's quality of life as perceived by the primary caregiver was significantly improved and the mean score was 3.31, 3.68, 3.56, 3.73, 3.75 at admission and week 1, 2, 3, 4. With the detailed item analysis, the following items were shown to be significantly improved: "clean bodies"(F=6.50, P=0.0001) "pain control"(F=18.01, P=0.0001) constipate"(F=2.96, P=0.0237) "sleep"(F=3.99, P=0.0048) "nausea/vomiting"(F=4.50, P=0.0022) "medical team's comfortable care" (F=3.95, P=0.0051) "family's care"(F=2.76, P=0.0317) "anxiety" (F=3.14, P=0.0177) "comfort"(F=3.63, P=0.0085) "treat with dignity"(F=3.32, P=0.0136). The item of "death is not the end of life rather the beginning" was significantly decreased(F=2.54, P=0.0450). 2) Patient's quality of life as perceived by the patient showed an improvement but statistically insignificant and the mean score was 3.63 and 3.83 at admission and week 1. With the detailed item analysis, the item of "pain control" was shown to be significantly improved(F=9.19, P=0.0251). 3) The quality of score in the last week of life of patient were 3.48, 3.51, 3.44, 3.46, 3.50, respectively, from 5 week prior to 1 week prior to death and these changes were insignificant. Conclusion : The findings of this study showed a positive effect of hospice service on quality of life of the terminal cancer patients admitted to the hospice unit. To improve the quality of life, we need first of all to develop hospice interventions with a particular emphasis on the spiritual aspect of patient. Secondly, measurement instruments need to be developed to collect the quality of life of the hospice patients who become weakened especially in the last weeks of their life and with this effort more representative data of hospice patients may be collected.

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The Actual Conditions of Palliative Radiation Therapy for Patients in the Hospice Ward (호스피스 병동에 입원한 암환자에서 실시한 고식적 방사선치료 실태)

  • Lee, Kyoung-Hwan;Sun, Der-Sheng;Shim, Byoung-Yong;Kim, Sung-Hwan;Kim, Chi-Hong;Kim, Su-Zy;Lee, Ok-Kyung;Shin, Ok-Kyung;Kim, Eun-Joung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.10 no.2
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    • pp.74-77
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    • 2007
  • Purpose: We evaluated how many patients received radiotherapy and how many those of them could not complete radiation therapy in Hospice Ward. Methods: We retrospectively reviewed the general characteristics in 33 patients who began to receive palliative radiation therapy, and radiation dose and reasons of not-completing radiation therapy in Hospice Ward of St. Vincent's Hospital. Results: Thirty three (8.2%) among 404 patients who had been admitted from November 2003 and October 2005 received palliative radiation therapy. The main indications of radiation therapy included brain metastasis, painful bone metastasis, painful tumor mass, and obstructive shortness of breath. Forty five percent of these patients could not complete. And 20% could receive less than 1/3 of planned radiation dose. They failed to complete the treatment often due to poor general rendition. Conclusion: Although palliative radiation therapy had been used frequently for patients with advanced cancer in Hospice Ward of St. Vincent's Hospital, but it was often not completed. With appropriate selection criteria of patients and shorter modification of radiation treatment period, more patients would be benefited with palliative radiation therapy in Hospice Ward.

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Comparison of Attitudes toward Death among Nursing Students from South Korea, Japan and Indonesia (한국.일본.인도네시아 간호대학생의 죽음에 대한 태도 비교)

  • Lee, So Woo;Lee, So Young;Lee, Young Whee;Kuwano, Noriko;Ando, Michiyo;Hayashi, Mariko;Wardaningsih, Shanti
    • Journal of Hospice and Palliative Care
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    • v.15 no.4
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    • pp.212-221
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    • 2012
  • Purpose: This study was performed to compare nursing students' attitudes toward death among South Korea, Japan and Indonesia, and to confirm the need for death education in nursing. Methods: A total of 294 nursing students completed a questionnaire titled as the Death Attitude Profile-Revised (Wong, Recker, Gesser. 1994). Participating students were from two nursing schools in South Korea, two in Japan and one in Indonesia. Data were analyzed by using descriptive statistics and inferential statistics including, ${\chi}^2$-test, ANOVA and multiple comparison analysis. Results: The total mean score of the DAP-R for the three countries combined was $3.84{\pm}0.73$. By country, the mean was the highest for Indonesian students ($4.32{\pm}0.71$), followed by Korean ($3.75{\pm}0.57$) and Japanese ($3.56{\pm}0.70$) respectively. In relation to subcategories, Indonesian students showed the highest mean score for death avoidance ($3.67{\pm}1.38$) and approach acceptance ($5.37{\pm}1.00$). Korean students marked the highest ($5.51{\pm}0.91$) in neutral acceptance and Japanese students scored the best ($3.63{\pm}1.46$) in escape acceptance. Nursing students who had an experience of caring terminally ill patients tended to be affirmative in approach acceptance (P=0.047). There were significant differences in each of the four subcategories except fear of death among the three countries (P<0.001). Conclusion: The above results indicate it is necessary to develop education programs based on each country's social and cultural background to help nursing students form desirable attitudes toward death.

Effect of Octreotide on Patients with Malignant Bowel Obstruction (악성장폐색 환자에서 Octreotide의 치료 효과)

  • Park, Ji-Chan;Jang, Yi-Sun;Jeon, Eun-Kyoung;Kim, Dong-Kyu;Lee, Wook-Hyun;Lee, Guk-Jin;You, Si-Young;Choi, Hyun-Ho;Park, Suk-Young
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.194-198
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    • 2009
  • Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

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Death Recognition, Meaning in Life and Death Attitude of People Who Participated in the Death Education Program (죽음교육 프로그램 참여자의 죽음인식, 생의 의미 및 죽음에 대한 태도)

  • Kang, Kyung-Ah;Lee, Kyung-Soon;Park, Gang-Won;Kim, Yong-Ho;Jang, Mi-Ja;Lee, Eun
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.169-180
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    • 2010
  • Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

Assessment of the Effect of a Public Health Clinics' Home-Based Terminal Cancer Patient Management in Collaboration with a Regional Cancer Center (경남 지역 암센터와 보건소 재가암환자 관리 서비스와의 연계 사업)

  • Song, Haa-Na;Kang, Myoung Hee;Lee, Gyeong Won;Kim, Hoon Gu;Lee, Won Sup;Kang, Jung Hun;Kang, Yoon Sik;Eun, Young
    • Journal of Hospice and Palliative Care
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    • v.16 no.1
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    • pp.10-19
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    • 2013
  • Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

The Effects of Smoking Cessation Coaching Program based on Motivation Stage to Stop Smoking of Patients at a Public Hospital (금연동기단계에 따른 코칭프로그램이 환자 금연에 미치는 영향)

  • Kwak, Mi-Young;Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.4
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    • pp.188-198
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    • 2016
  • This study examined the effects of a smoking cessation coaching program based on the motivation stage applying the Transtheoretical Model to stop the smoking of patients in terms of the amount of smoking, nicotine dependence, CO level, and urine cotinine. The study design was a multi-repeat multiple repeat intermittent time series study with one-group, a pre-post design. The participants were 47 smoking patients (44 males and 3 females), who were treated at a public hospital in N city. The participants were 4 (8.51%) subjects in the action stage and 43 subjects (91.49%) in the preparation stage of the motivation stage. The coaching program intervention was conducted at the first day, second week, and 6th week. The smoking cessation maintenance of the subjects was checked at the 12th week. A chi-square test and t-test were used to analyze the data. The subjects in the action stage were kept under the condition of no smoking and nicotine dependence. After the program of subjects in the preparation stage, the amount of smoking, nicotine dependence, and CO level were significantly lower compared to the pre-test (p<.001). The findings suggest that the coaching program based on the motivation stage was effective in improving the smoking cessation for patients who smoke. On the other hand, the patients in the smoking cessation program may require much more financial assistance than those of healthy people. A greater workforce and budget will be needed for patients to stop smoking.

Data Mining Approaches for DDoS Attack Detection (분산 서비스거부 공격 탐지를 위한 데이터 마이닝 기법)

  • Kim, Mi-Hui;Na, Hyun-Jung;Chae, Ki-Joon;Bang, Hyo-Chan;Na, Jung-Chan
    • Journal of KIISE:Information Networking
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    • v.32 no.3
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    • pp.279-290
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    • 2005
  • Recently, as the serious damage caused by DDoS attacks increases, the rapid detection and the proper response mechanisms are urgent. However, existing security mechanisms do not effectively defend against these attacks, or the defense capability of some mechanisms is only limited to specific DDoS attacks. In this paper, we propose a detection architecture against DDoS attack using data mining technology that can classify the latest types of DDoS attack, and can detect the modification of existing attacks as well as the novel attacks. This architecture consists of a Misuse Detection Module modeling to classify the existing attacks, and an Anomaly Detection Module modeling to detect the novel attacks. And it utilizes the off-line generated models in order to detect the DDoS attack using the real-time traffic. We gathered the NetFlow data generated at an access router of our network in order to model the real network traffic and test it. The NetFlow provides the useful flow-based statistical information without tremendous preprocessing. Also, we mounted the well-known DDoS attack tools to gather the attack traffic. And then, our experimental results show that our approach can provide the outstanding performance against existing attacks, and provide the possibility of detection against the novel attack.

Effect of 1 Year E-mail Nutrition Education after Face-to-Face Encounter at Worksite: Changes in Cardiovascular Risk Factors (면대면 영양교육 후 1년간의 E-mail 영양교육이 직장인 남성의 심혈관 질환 위험인자 감소에 미치는 효과)

  • Oh, Hye-Sun;Jang, Mi;Hwang, Myung-Ok;Cho, Sang-Woon;Paek, Yun-Mi;Choi, Tae-In;Park, Yoo-Kyoung
    • Journal of Nutrition and Health
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    • v.42 no.6
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    • pp.559-566
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    • 2009
  • Effective nutrition educations for prevention of chronic diseases for the general population are of great importance these days. The purpose of this study was to evaluate the feasibility of nutrition education for cardiovascular risk factor reduction by e-mail education in male workers. The participants were divided into three groups by age; 28-39 age group, 40-49 age group, and 50-59 age group who got regular checkups for anthropometry and biochemistry. The 1 year program consisted of 15 topics containing information about metabolic syndrome (MS) and healthy eating behavior (intake of salt, fat and alcohol). Seven hundred thirty nine participants volunteered for the study [28-39 age group, n = 240; body mass index (BMI) = 24.9 $\pm$ 2.7 kg/m$^2$: 40' group, n = 276; BMI = 24.8 $\pm$ 2.6 kg/m$^2$: 50' group, n = 223; BMI = 24.9 $\pm$ 2.7 kg/m$^2$]. Percentage body fat (p < 0.05) and percentage of abdominal fat (p < 0.05), total cholesterol (p < 0.05), systolic blood pressure (p < 0.05), and diastolic blood pressure (p < 0.05) were significantly decreased in all participants after the 1 year program. The total number of participants who had MS was decreased from 216 to 199 and especially the incidence of MS was decreased 27% in the group of subjects who were under the age 39. The e-mail worksite nutrition education program shows a substantial contribution to the development of effective CVD and chronic disease control and lifestyle nutrition educations that are applicable to and attractive for the large population at risk.

Antimutagenic Effect and Cytotoxicity to Human Cancer Cell Lines of Colored Potato Extracts (유색감자 추출물의 항돌연변이 및 항암 활성)

  • Park, Young-Eun;Jeong, Jin-Cheol;Cho, Huyn-Mook;Hwang, Young-Sun;Lee, Hyeon-Jin;Choi, Su-San-Na;Lee, Su-Jin;Park, Eun-Sun;Ko, Eun-A;Kim, Nan-Sol;Lim, Jung-Dae;Choung, Myoung-Gun
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.53 no.1
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    • pp.75-84
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    • 2008
  • Colored potatoes are an excellent source of dietary polyphenols including anthocyanins. Generally, anthocyanins from fruits and vegetables exhibit anti-carcinogenesis and anti-cancer properties in vitro test. This experiment was conducted to know the effects of colored potato extracts contained anthocyanins on antimutagenic activity and anticancer activity to six human cancer cell lines containing LNCaP (androgen-dependent) prostate cancer cells. Extracts of three colored potatoes ('Hongyoung', 'Jayoung' and 'Jasim') and the white potato ('Superior') cultivars were used in this study. The extracts of three colored potatoes inhibited the mutagenicities induced by direct mutagen such as 4-nitro-quinoline-1-oxide (4-NQO) and another indirect mutagens of bezo(a)pyrene (BaP). Also, the extracts of 'Hoyoung' and 'Jayoung' showed higher antimutagenic activity than 'Jasim' and 'Superior' against to direct or indirect mutagen on both strains of TA98 and TA100. The activity of growth-inhibitory of extract of four potato cultivars were screened by SRB (sulphorhodamine B) method on diverse human cancer cells representing different types of cancers. Among the extract of four potato cultivars, the extract of 'Jasim' showed moderate inhibition on proliferation of LNCaP, ACHN and MOLT-4F cells and did not inhibit the proliferation of other cancer cells. On the other hand, extract of 'Superior' did not inhibit the proliferation of any tested cancer cell lines. However, the extracts of 'Hongyoung and Jayoung' inhibited the proliferation of cancer cells with $GI_{50}$ values ranging from 2.5 to $30\;{\mu}g/mL$. On the basis of the $GI_{50}$ values, it is clear that LNCaP cells were more sensitive to extracts of colored potato cultivars than other cancer cells. The extract of 'Jayoung' at $30\;{\mu}g/mL$ were more active and inhibited cell proliferation, and induced apoptosis in LNCaP cells. This result revealed that the extracts of colored potatoes are expected to be good candidate for development into source of antimutagenic and anticancer agent.